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Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine the severity of disease or treat a variety of diseases, including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other abnormalities within the body.
Nuclear Medicine Imaging is a test that produces pictures (scans) of internal body parts using small amounts of radioactive material. Because of the special materials and equipment needed, these scans are usually done in the radiology or nuclear medicine department of a hospital. This test is used to provide images of organs and areas of the body that cannot be seen well with standard X-rays. Nuclear medicine scans use a special camera (gamma) to take pictures of tissues and organs in the body after a radioactive tracer (radionuclide or radioisotope) is put in a vein in the arm and is absorbed by the tissues and organs. The radioactive tracer shows the activity and function of the tissues or organs.
Nuclear medicine scans can help doctors find tumours and see how much the cancer has spread in the body also called the cancer’s stage. They may also be used to determine if treatment is working. These tests are painless and usually done as an outpatient procedure. The specific type of nuclear scan you’ll have depends on which organ the doctor wants to look into. Nuclear scans are safe tests. The doses of radiation are very small, and the radionuclides have a low risk of being toxic or causing an allergic reaction.
Nuclear scans make pictures based on the body’s chemistry like metabolism.
Body tissues affected by certain diseases such as cancer may absorb more or less of the tracer than normal tissues. Special cameras pick up the pattern of radioactivity to create pictures that show where the tracer travels and where it is collected. If cancer is present, the tumour may show up on the picture as a “hot spot” – an area of increased cell activity and tracer uptake. Depending on the type of scan done, the tumour might instead be a “cold spot” – a site of decreased uptake and less cell activity.
Nuclear scans may not find very small tumours, and cannot always tell whether a tumour is really cancer. These scans can show some internal organ and tissue problems better than other imaging tests, but they don’t provide very detailed images on their own. Because of this, they are often used along with other imaging tests to give a complete picture. Some nuclear scans are also used to measure heart function.
In most cases a tracer or radionuclide that sends out small doses of radiation is given. Some are swallowed while others are put into a vein or inhaled as a gas. Over time, the tracer collects in the part of the body that is being tested. This can take from a few seconds to several days. The collected tracer sends out gamma rays that are picked up by a special camera which are processed by a computer, which turns them into 2D or 3D pictures and are interpreted by a specialist.
Some of the nuclear medicine scans most commonly used for cancer are:
The steps needed to prepare for a nuclear medicine scan depend on the type of test and the tissue that will be studied. Some scans require fasting for 2 to 12 hours before the test. For others, you may be asked to take a laxative or use an enema. The medical team may ask the patient to avoid some medicines, drugs, vitamins and herbs before the test. Reactions to the radioactive material are very rare. The known allergies must be conveyed to the medical team. The radioactive material may be given anywhere from a few minutes to many hours before the test.